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Online Resumes with "Medical Claims"



Claims Examiner - 20 Years of Experience - Near 78754

315-492-5055 9/03-6/04-Admitting Clerk/Patient Access-Register and admit all outpatient, in patient and emergency room patients. Other responsibilities include putting together folders for pre-admission testing and surgeries running the diagnostic desk bringing patients to their rooms getting consent signatures from the nursing home floor patients assisting the charge person on duty as well as numerous tasks. 713-442-1500 8...

Tags for this Online Resume: Medical claims processor, Long term care claim processor, Austin, Medical claims

Featured Profile

Controller- 20 Years of Experience - Southeastern United States

Quality-focused accounting professional with cross-functional competencies in all phases of accounting, payroll processing and financial analysis. An advocate of strict regulatory compliance. Comprehensive knowledge and "hands-on" experience preparing financial statements, identifying and resolving accounts receivable, maintaining payroll, and reconciling payroll and sales tax. Solid knowledge of Generally Accepted Accounti...

Ideal Companies: Google, Apple, US Government, AFLAC, State Farm, AAA, BlueCross/BlueShield, ationwide, Allstate, Geico, Progressive, Fidelity Investments, Morgan Stanley, Deloitte, Charles Schwab, Merrill Lynch

Tags for this Online Resume: Accounts Receivable, Automotive, Billing, Coding, Insurance, Software, Financial, Financial Reporting, General Ledger, Financial Statement Preparing, Best Practices, Team Building, Inventory Control, Payroll, Information Systems Management, Personnel Benefits Administration, Financial Planning, Financial Reconciliation, Regulatory Compliance, Computer Networks, Business Knowledge, Effective Communication Skills, Controller, Bookkeeper, Accounts Payable Specialist, Lafayette, Alabama, 36862, Training, GAAP, Auditing, Cash Flow Analysis

Medical or Health Services Manager - Near 07102

SUMMARY OF CAREER PROFILE I am a highly creative and innovative Healthcare professional with strong Audit, Claims and Benefit Test Analyst background, 25 years experience.

Tags for this Online Resume: Benefits, Audit, Coding, Management, Test, Pricing, Process Improvements, Quality, Quality Assurance, Applications, Time Management, Organizational Skills, Microsoft Office, Attention to Details, Medical Claims Examiner, Enrollment Specialist, Analytical Skills

Computer Programmer - 17 Years of Experience - Near 55122

SUMMARY MORE THAN 17 years programming and application development experience. I have been working in claims processing for 17 years and combined pharmacy for 10 years. I was involved in the conversion of pharmacy batch processing to a real time server application using pega 4.2. and then same application conversion to 5.5. I have worked with many out sourced companies within blue cross to ensure the correct procedures are ...

Tags for this Online Resume: Application Development, Batch Processing, CA-Easytrieve, IBM DB2 Database, IBM IMS, Operating Systems, Oracle, Programming, Realtime, SAS, PEGA

Billing/Coding Specialist - 4 Years of Experience - Near 29036

Professional Summary Medical Claims Biller with experience in CPT, ICD9 and ICD10 coding. Experience with billing to insurance companies and posting insurance payments and patient payments. Also experience with Electronic Medical Records.

Tags for this Online Resume: Teller, Insurance, Medical, Medical Records, Deposits, Billing, Coding

Market Conduct, Compliance, Medical Claims, Appeals - 16 Years of Experience - Near 53154

CAREER SUMMARY Dedicated health insurance professional with more than 16 years of experience in Claims Operations, Market Conduct and Regulatory Compliance along with Underwriting. Advanced skills in analyzing data and implementing improvements that enhance operations. A proven innovator in obtaining results with an acute attention to detail. Skills and abilities include: Project leadership, Medical terminology, Regulation ...

Tags for this Online Resume: Project Leader, Medical Records, Risk Assessment, Underwriter, Appeals, Grievances, Critical Thinking, Milwaukee, Microsoft Office, Insurance, Medical

Experienced Benefits Professional

Dedicated knowledgable benefits leader with exceptional people skills

Ideal Companies: Zales, Flour, Nokia

Tags for this Online Resume: Benefits Manager

Manager - 20 Years of Experience - Near 94513

SUMMARY: Highly-skilled IT professional with 25 years of experience in architecting, data modeling and implementing EDW and BI with analytical reporting solutions in mainframe, client server, desktops, web-based in Healthcare MDM, Labs and Pharmacy, BI Analytics, HL7 and EDI x 12 transactions, Insurance, Finance, Retails, Utility, HR, CRM, Telecom. wireless environments. * Managed pharmacy and MDM (pharmacy, medical, claims...

Tags for this Online Resume: Teradata, Teradata (NCR Data Warehouseing product), IBM DB2 Database, Java Programming Language, Architect, Billing, Informatica, Informatica PowerCenter, PowerCenter, Project Management

Billing/Coding Specialist - 9 Years of Experience - Near 45237

Summary: Dependable and professional Medical Claims Administrator with 10+ years experience in processing and coding medical and vision claims, ensuring all required criteria are met before eligible payments or denials are made. Consistently meets targets through significant knowledge of medical and insurance industries and terminologies, while using appropriate and accurate coding. Ready to use skills for high level of cus...

Tags for this Online Resume: Claim Processing, Coding, Customer Service, IBM AS/400, Insurance, Medical, Microsoft, Microsoft Excel, Life Insurance, Microsoft Word

Programmer Analyst - 7 Years of Experience - Near 72211

SUMMARY OF QUALIFICATIONS: * Over ten years' extensive experience in SAS programming on Windows and UNIX platforms, including nine years' experience working on Medicare and Medicaid national warehouse databases, mainly in manipulating large complex medical datasets and medical claims data (inpatient, outpatient, and pharmacy claims). * Solid experience in data extraction, transformation, and loading to data warehouse Data c...

Tags for this Online Resume: SAS, SQL, Statistical Analysis, Data Management, Medical, Oracle database, Data Validation, Data Extraction, Survy data analysis, Modeling, SAS ODS Report, Generate tables and graphics

Quality Assurance Specialist - 5 Years of Experience - Near 11435

SUMMARY * 6 plus years of experience in Manual of Web, Client Server applications. * Expertise in writing Test Plans, Test Scenarios, Test cases, executing Test cases and logging Defects found. * Experience with Test Case Management using HP Quality Center/ALM. * Strong understanding of SDLC phases and models. Good Knowledge in Software Testing Life Cycle and Defect Life Cycle. * Worked on Agile and waterfall methodologies....

Tags for this Online Resume: EDI, Electronic Data Interchange, Health Insurance Portability And Accountability Act, Extensible Markup Language (XML), HP, Oracle, Test, Test Plan, Microsoft Windows, Test Cases

Materials Manager

SUMMARY Healthcare professional with extensive experience in training, management, reconciliation, audit, Medicaid and Medicare regulations. Experienced with federal regulations and compliance. Experienced with analysis and preparing reports for management. Medical claims Adjudication and Network Management.

Tags for this Online Resume: Management, Policies and Procedures, Audit, Business Analysis, Compliance, Medicare, Cms, Complaints, Business Analyst, Integrate